Template

Safety Champion Pulse Report

by Kevin Williams, from the Community

Use this Safety Champion Pulse Report template to gauge safety performance on active jobsites. The questionnaire helps teams record good catches, summarize 1:1 safety discussions, rate JHA communications, and identify training needs and improvement actions that support Drive ZERO initiatives. It also prompts reflection on company mission and values, plus examples of getting awkward for safety. Use insights to prioritize actions and strengthen a safe work environment.

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Safety Champion Progress Review
Use this Safety Champion Progress Review template to assess and coach on site Safety Champions. Evaluate leadership, communication and intervention using clear good, very good and excellent criteria. Capture innovation ideas, barriers, auditor comments and Safety Champion feedback. Record names, roles, locations and dates, and include signatures to confirm actions. The template helps drive worker engagement, improve toolbox talks and encourage proactive health and safety discussions across operatives and subcontractors.
by David Marshall, from the Community
Downloads: 10+
Get
Template
IDC Safety Champion Employee Interview
This IDC Safety Champion Employee Interview template helps identify safety leaders and capture frontline insights across key areas of the workplace. Use guided questions on material handling, tools and equipment, hazard identification, and housekeeping to surface risks and improvement ideas. Record team member details, shifts, and areas, then prioritize actions to reduce manual handling, replace improper tools, address top hazards, and raise cleanliness standards. Ideal for manufacturing and industrial teams seeking to strengthen safety culture and continuous improvement.
by Nate Schreiber, from the Community
Downloads: 0
Get
Template
IDC Safety Champion Observation Form
This IDC Safety Champion Observation Form helps supervisors and safety champions document observations on PPE compliance, tool and equipment selection and use, hoists and lifting devices, ergonomics and body mechanics, housekeeping and 5S, and potential line-of-fire, pinch, trip, and slip hazards. Capture safe practices, identify at-risk behaviors, discuss findings with workers, and propose corrective actions to drive continuous improvement in workplace safety across sites, shifts, and processes.
by Nate Schreiber, from the Community
Downloads: 0
Get
Template
Safety Unit Champion Hazard Survey Template
This Safety Unit Champion Hazard Survey template helps healthcare departments identify and correct hazards across patient management, maintenance, security, electrical safety, storage areas, and exits. Assess safe patient repositioning and transfers, staff training on lifting equipment, condition of lighting, flooring, and appliances, and food labeling. Verify security practices including visible badges, alarm functionality, and access to escorts; check electrical cord condition, proper use of power taps, and lockout/tagout procedures. Review storage ergonomics and housekeeping, and confirm exit routes, signage, emergency lighting, evacuation plans, and door operation. Use findings to drive corrective actions and regulatory compliance.
by Ryan Geib, from the Community
Downloads: 0
Get

Safety Champion Progress Review

Use this Safety Champion Progress Review template to assess and coach on site Safety Champions. Evaluate leadership, communication and intervention using clear good, very good and excellent criteria. Capture innovation ideas, barriers, auditor comments and Safety Champion feedback. Record names, roles, locations and dates, and include signatures to confirm actions. The template helps drive worker engagement, improve toolbox talks and encourage proactive health and safety discussions across operatives and subcontractors.

by David Marshall, from the Community

10+

Get

Template

IDC Safety Champion Employee Interview

This IDC Safety Champion Employee Interview template helps identify safety leaders and capture frontline insights across key areas of the workplace. Use guided questions on material handling, tools and equipment, hazard identification, and housekeeping to surface risks and improvement ideas. Record team member details, shifts, and areas, then prioritize actions to reduce manual handling, replace improper tools, address top hazards, and raise cleanliness standards. Ideal for manufacturing and industrial teams seeking to strengthen safety culture and continuous improvement.

by Nate Schreiber, from the Community

Get

Template

IDC Safety Champion Observation Form

This IDC Safety Champion Observation Form helps supervisors and safety champions document observations on PPE compliance, tool and equipment selection and use, hoists and lifting devices, ergonomics and body mechanics, housekeeping and 5S, and potential line-of-fire, pinch, trip, and slip hazards. Capture safe practices, identify at-risk behaviors, discuss findings with workers, and propose corrective actions to drive continuous improvement in workplace safety across sites, shifts, and processes.

by Nate Schreiber, from the Community

Get

Template

Safety Unit Champion Hazard Survey Template

This Safety Unit Champion Hazard Survey template helps healthcare departments identify and correct hazards across patient management, maintenance, security, electrical safety, storage areas, and exits. Assess safe patient repositioning and transfers, staff training on lifting equipment, condition of lighting, flooring, and appliances, and food labeling. Verify security practices including visible badges, alarm functionality, and access to escorts; check electrical cord condition, proper use of power taps, and lockout/tagout procedures. Review storage ergonomics and housekeeping, and confirm exit routes, signage, emergency lighting, evacuation plans, and door operation. Use findings to drive corrective actions and regulatory compliance.

by Ryan Geib, from the Community

Get

Safety Champion Pulse Report

About author

You might also like

Safety Champion Progress Review

IDC Safety Champion Employee Interview

IDC Safety Champion Observation Form

Safety Unit Champion Hazard Survey Template

You might also like

Safety Champion Progress Review

IDC Safety Champion Employee Interview

IDC Safety Champion Observation Form

Safety Unit Champion Hazard Survey Template